氨茶碱治疗脓毒症相关性膈肌功能障碍的疗效观察

目的观察氨茶碱治疗脓毒症相关性膈肌功能障碍的疗效.方法选取脓毒症患者55例,随机分为对照组及观察组,对照组给予基础治疗,观察组在对照组基础上给予氨茶碱治疗.在入组时(T1)、氨茶碱使用后24 h(T2)、使用后72 h(T3)三个时间点分别测量膈肌增厚率(DTF),记录两组患者治疗结局及药物不良反应.结果观察组中T2及T3时DTF[(16.4±1.83)%,(23.0±1.77)%]高于对照组[(15.4±1.52)%,(14.7±1.62)%](P<0.05).对照组患者T2、T3时DTF[(15.4±1.52)%,(14.7±1.62)%]低于T1时DTF[(16.9±1.42)%](P<0.05).观察组中T3时DTF[(23.0±1.77)%]高于T1、T2时DTF[(16.2±1.76)%,(16.4±1.83)%](P<0.05).观察组患者总机械通气时间、ICU住院时间[(4.8±2.5)d,(6.3±2.42)d]明显短于对照组[(6.9±2.7)d,(8.7±2.46)d](P<0.05),两组住院死亡率差异无统计学意义(P>0.05).两组患者用药期间不良反应发生率差异无统计学意义(P>0.05).结论氨茶碱对脓毒症相关性膈肌功能障碍有治疗效果.

Objective To investigate the eficacy of aminophyline in the treatment of sepsis-induced diaphragmatic dysfunction.Methods Fifyfive patients with sepsis were randomly divided into control group and treatment group.The control group was given basic treatment,and the treatment group was given aminophyline and basic treatment.The diaphragmatic thickening fraction(DTF)was measured by ultrasound at the time of enrollment(T1),24 hours later(T2)and 72 hours later(T3)after intravenous injection of aminophylline.The treatment outcomes and adverse drug reactions of 2 groups were recorded.Results The DTF at T2 and T3 in the treatment group[(16.4±1.83)%,(23.0±1.77)%] was significantly higher than that in the control group[(15.4±1.52)%,(14.7±1.62)%](P<0.05).In the control group,the DTF at T2 and T3[(15.4±1.52)%and(14.7±1.62)%],respectivelywas significantly lower than that at T1 DTF[(16.9±1.42)%](P<0.05).There was no significant difference in DTF between T2 and T3 in the control group.In the treatment group,the DTF at T3[(23.0±1.77)%] was significantly higher than that at T1 and T2[(16.2±1.76)%,(16.4±1.83)%],respectively(P<0.05).The ventilation time[(4.8±2.5)d vs.(6.3±2.42)d] and ICU length of stay[(6.9±2.7)d vs.(8.7±2.46)d]were all shorter in the treatment group than in the control group(P<0.05).There was no significant difference in the mortality between the two groups(P>0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).ConclusionAminophylline has therapeutic effects on sepsis-induced diaphragmatic dysfunction.